In a recent report on Emerging Infectious Diseases, the U.S. Centers for Disease Control and Prevention highlighted the increasing cases of leprosy, also known as Hansen’s disease, in Florida. This infectious disease primarily affects the skin and nervous system, but early detection can lead to successful treatment.
Historically, leprosy has been uncommon in the United States. However, in the past decade, its prevalence has more than doubled in the South. According to research published in the CDC’s August issue of the Emerging Infectious Diseases, Central Florida has accounted for 81% of reported cases in the state and nearly one-fifth of reported cases nationwide. This suggests that Central Florida may be an endemic location for the disease.
Due to the increasing number of cases, particularly in Central Florida, the report’s author recommends that physicians inquire about their patients’ travel history to or residence in Florida when treating symptoms of leprosy.
According to the National Hansen’s Disease Program, Florida was among the top reporting states with nearly 30 new cases of leprosy reported in 2020 out of the 159 cases nationwide. The Florida Department of Health reported 19 cases from July 2022 to July 2023, including one case in Palm Beach County, South Florida.
If left untreated, leprosy can progress to severe complications such as paralysis, blindness, physical disfigurement, and deformities in the hands and feet. Symptoms include loss of sensation, nasal congestion, and dry, stiff, and sometimes painful skin.
Dr. Nicole Iovine, chief hospital epidemiologist and infectious disease physician at the University of Florida, explained the main distinction between a rash and leprosy is the loss of sensation in the affected area, as she told WESH.
By examining a leprosy patient, the authors of the report gained further insight into disease transmission. “Whereas leprosy in the United States previously affected individuals who had immigrated from leprosy-endemic areas, about 34% of new cases between 2015 and 2020 appeared to be locally acquired,” the report states. The World Health Organization reports over 200,000 cases of leprosy annually across 120 countries. Although the reason for the rising cases in Florida remains unclear, there is some support for the theory that the migration of individuals with leprosy to Central Florida is fueling locally acquired transmission.
“Prolonged person-to-person contact through respiratory droplets is the most recognized route of transmission,” the report explains. However, the specific mode of transmission, particularly in Central Florida, remains uncertain.
During contact tracing investigations in Central Florida, researchers found no associated risk factors such as travel, exposure to animals, occupation, or personal contacts. “The absence of traditional risk factors in recent leprosy cases in Florida, along with a high proportion of residents spending significant time outdoors, supports the investigation into potential environmental reservoirs as a source of transmission,” states the report.
Cindy Goodman, a health reporter for the South Florida Sun Sentinel, can be reached at [email protected].
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